Asthma in Adults?

Asthma in Child ?

What you should know When Child Have Asthma?

How Can Asthma Attack Be Prevented?

Asthma In Child

 Asthma is a desperate struggle for breath that sufferers relive over and over again. The condition affects 4.1 million children under the age of 18, but many others have a "hidden" or undiagnosed problem. So every parent should learn how to recognize the symptoms of asthma and how to control them.

Asthma is the leading serious chronic illness among children. It's the main cause of school absenteeism and the third highest cause of hospitalization in children under the age of 15. But medical advances have greatly improved the outlook for a child with asthma. With proper treatment, almost everyone with the condition can go to school and even participate in sports.

In asthma, normal functions designed to protect the lungs from harmful materials (muscle contraction, mucous membrane swelling and mucus formation) go into overdrive. The airways are abnormally sensitive to infection, cold weather and allergies, so the muscles tighten in what is known as a bronchospasm and the mucous membranes swell, reducing the diameter of the airways. In addition, mucus production becomes extreme, sometimes forming sticky plugs in the bronchial tubes.

Asthma affects people of any sex, age and race, but there are some factors that may increase a child's risk:

• Inflammation. Chronic irritation of the airways is a hallmark in all asthma patients. Recent studies indicate that it is -- at least in part -- a cause of the disease. This inflammation is triggered by allergy, infections and air irritants.

• Allergies. About 75-80 percent of children with asthma have significant allergies, which induce airway inflammation. Studies indicate that allergies produce both immediate and delayed reactions because chronic airway inflammation can cause scarring.

• Tobacco Smoke. Recent studies suggest that children of smokers are twice as likely to develop asthma as the children of non-smokers. Even apparently healthy babies born to women who smoked during pregnancy have abnormally narrowed airways that may predispose them to asthma.

• Race. African-Americans and Hispanics have a higher risk of asthma than non-Hispanic whites (see "Race Disparity").

Signs that a child may have asthma include a persistent dry cough, nighttime coughing that disturbs sleep, wheezing, and coughing or shortness of breath with physical activity. Wheezing, though characteristic of asthma, is not its most common symptom. Coughing, on the other hand, is noted with even "hidden" or undiagnosed asthma.

Infants who have rattle-like coughs, rapid breathing or excessive bouts of pneumonia or chest colds should be evaluated for asthma. Also, if your child is diagnosed with bronchitis, consider getting a second opinion because this condition is rare in children and is usually misdiagnosed asthma. (Bronchiolitis, a viral infection of the lower respiratory tract, is a different disease that occurs in infants under 18 months of age.) Obvious wheezing episodes might not be noted until after 18-24 months of age. Chest tightness and shortness of breath are other signs of asthma that may occur alone or in combination with any of the above symptoms. However, since any of these symptoms can arise without asthma, other respiratory diseases must always be considered.

Asthma is a chronic disease that causes breathing problems, known as attacks or episodes often triggered by the following conditions:

• Allergies. During an allergic reaction, chemicals, such as histamine, are released from specialized cells. These substances cause mucous membrane swelling, excessive mucus secretion and muscle contraction in the airways. Dust, pollen, mold, food, animals, etc., can all cause allergic reactions.

• Vigorous Exercise. Activities such as running can trigger an episode in over 80 percent of children with asthma.

• Respiratory Infections. These frequently trigger asthma attacks in much the same way allergies do.

• Irritants. Cigarette smoke, air pollution, strong odors, aerosol sprays and paint fumes are some of the substances which can irritate the tissues of the lungs and upper airways. The reactions (coughing, wheezing, runny nose, watery eyes) they produce can be identical to those produced by allergens.

• Emotions. Children do not develop asthma as a result of psychological problems. However, crying, laughing or yelling in response to an emotional situation involves deep, rapid breathing, which can sometimes trigger an asthma attack.

• Weather. Studies have demonstrated that breathing cold air provokes an attack in most children with asthma.

Although asthma cannot be cured, in most cases its frequency and severity can be reduced so that it does not interfere with normal activities, especially since most asthma attacks develop gradually over days. Many children outgrow asthma as they get older and their airways get bigger, but they are still at higher risk for it as adults. These steps can help you and your doctor control your child's asthma:

• Anti-inflammatory agents act directly to reduce the inflammatory response of the airways. They come in pill and aerosol form. The oral form may cause more side-effects (nausea, vomiting, tremor, hyperactivity, headaches, etc.) than the inhaled type (throat irritation and coughing).

• Anti-Allergy drugs help prevent triggers from causing attacks, but they do not work after one starts.

• Once an attack occurs, bronchodilators may be used to relax the muscles of the airways and open them up. They are available as tablets and sprays, though the latter is usually preferred because it acts faster and has fewer side-effects. However, young children (usually under 8 or 10) cannot use sprays appropriately so oral medication is used. Bronchodilators are best used as needed and with caution.

• Finally, corticosteroid medications are highly effective in controlling asthma and reversing severe episodes. (Corticosteriods are hormones produced by the body. They're not related to the steroids athletes take.) However, these drugs should be limited to severe episodes or chronic asthma that cannot be controlled with other medications because frequent use of them can cause weight gain, stomach ulcers, high blood pressure, adrenal gland suppression, growth suppression in children and many other side effects. But uncontrolled severe asthma is potentially fatal, representing a much greater risk than corticosteroids.

If your doctor recommends using a meter, keep a chart of your child's peak flow rates and discuss the readings with your doctor to determine what is normal for your child and what calls for immediate action. Also, have your doctor outline the medication and dosage you should give your child at these times. If your child does not respond to this treatment, call your doctor for further instructions. Early aggressive treatment will usually prevent progression into a severe acute episode.

The National Heart, Lung and Blood Institute warns that it is dangerous to rely too heavily on using inhaled bronchodilators since they only provide temporary relief of symptoms and do not deal with the underlying inflammation. Additionally, patients may be less cautious about avoiding triggers if they only depend on a quick-fix. Overuse of any medication that does not treat the respiratory inflammation may increase the possibility of death from asthma.

It is important to remember that while asthma must be controlled, it should not keep your child from normal childhood activities. Don't keep him or her cooped up out of fear of an attack. Take a positive approach to the problem. The American Lung Association (ALA) affirms that learning to control asthma can help a child gain confidence and learn self-discipline and personal responsibility.

You should encourage physical activity within your child's limits. Fortunately, the vast majority of children with asthma can participate in all activities -- including vigorous sports like track, basketball and soccer. At the 1984 Olympics there were 34 medal winners who had asthma. Also, the ALA sponsors about 141 summer residential or day camps around the country for children with asthma. For more information on the camps, asthma management, stop smoking programs or other asthma projects, call the ALA at 800-586-4872, which will automatically dial your local ALA chapter.

In 1985 the prevalence of asthma among African Americans was 7 percent greater than among whites. By 1991, the difference was 21 percent. And among Hispanic children 6 months to 11 years old, 20.1 percent suffered from asthma -- more than any other ethnic group. This racial disparity is particularly dramatic in one study that shows from 1982 to 1986, 82 percent of those hospitalized for asthma in New York City were African Americans or Hispanics and those two groups accounted for 76 percent of asthma deaths. The reason certain ethnic groups are harder hit by asthma seems to be more economic than genetic. Lack of adequate medical attention leads to a failure to diagnose asthma and to keep it under control. Also, urban living conditions, which are usually crowded and less sanitary, lead to a greater exposure to allergens.

In fact, a study in the medical journal Lancet in 1992, confirmed that avoiding exposure to allergens in the first year of life can help prevent or delay childhood asthma. In this study, infants in one group were breast fed or given allergen-free formula. Their diets were free of cows' milk, eggs, fish, nuts, soy products, wheat and oranges (breastfeeding mothers followed the same diet). The bedrooms and living areas of this group were cleaned with anti-dust mite solution for the first year of life (dust mites are microscopic bugs that cause allergies to dust). The infants in the other group ate freely and lived in untreated environments. After one year, the specially treated group had a 13 percent rate of allergies and asthma while the untreated one had a 40 percent rate.

The following tips can help your child avoid triggers and thus lessen the frequency and severity of his attacks:

• Make sure your child's home is smoke-free.

• Keep your child's room as uncluttered and dust-free as possible by: removing any carpets or rugs so the floor is easy to clean (washable throw rugs can be used); making sure stuffed animals are washable or are kept covered with plastic when not in use; using washable drapes on the windows instead of venetian blinds; avoiding open book shelves, upholstered furniture, fuzzy blankets or feather- or wool-stuffed comforters and pillows; using a washable mattress cover; and washing all the bedding once a week in hot water. Dust mite resistant solutions, mattress covers and pillows are also available.

• The National Institutes of Health recommends steam or hot water heat instead of hot air heat for asthmatics. If there is a hot air furnace outlet in your child's room, install a filter made of several layers of cheesecloth or some other adequate material (such as old nylon hose) and change it frequently. Also, seal holes and cracks in the floor around heating or other pipes with tape.

• Clean your child's room daily, and once a week do a thorough cleaning of floors, furniture, tops of doors, window frames, etc., with a damp cloth or oil mop. Air the room while cleaning, but then keep windows closed.

• Strong odors often provoke symptoms. The National Allergy and Asthma Network/Mothers of Asthmatics (800-727-8462), advises that parents use the following away from children: aerosol cans, paints, insecticides, detergents, chemicals, household cleaners, strong soaps, perfumes, cosmetics, air fresheners, potpourri.

• Test children to see if they are allergic to animal dander (small scales from animal hair or bird feathers). Cats, dogs, birds, etc., can cause problems for asthmatics.

• Help your child avoid breathing cold air. In cold weather, have him cover his nose and mouth with a scarf or cold weather mask (available in drug stores).

• Make sure your child gets regular exercise to improve the strength of the lungs and airways. If vigorous exercise triggers an attack, talk with your pediatrician. Adjusting the medication or exercise may help.